Safely Manage Joint Inflammation: Curcumin

By Susan Evans

Enhanced Bioavailability

Despite its clear ability to reduce markers of inflammation in laboratory studies, development of curcumin as a human nutraceutical has been hampered by one major obstacle. Curcumin in its natural state is not well absorbed from the human intestinal tract. In addition, it appears to be rapidly broken down both in the intestine and after absorption into the bloodstream.14,16,17

That has meant the need to deliver very large doses of the supplement, doses so large that in some cases people have balked at the size and number of capsules required to achieve a good effect.14,18,19 Doses as high as 12,000 mg (that's 12 grams, more than a third of an ounce) have been used in efforts to get significant amounts of curcumin into the bloodstream.18 At such high doses, even curcumin can produce uncomfortable symptoms such as abdominal fullness and bloating, though no true toxicity has been demonstrated.19

To improve effectiveness and reduce the dose size required, researchers in the rheumatoid arthritis study made use of a specialized curcumin complex that has increased bioavailability. Bioavailability is a measure of how much of a given dose of a drug or nutrient makes it into the bloodstream for delivery to target tissues.

Researchers showed in 2008 that curcumin's bioavailability could be enhanced through a very simple expedient process.14 Curcumin is first extracted from the turmeric root. Next, it is highly purified, and then reconstituted with certain other components of the original turmeric plant. Those constituents are thought to increase intestinal absorption and also reduce natural breakdown of curcumin in the body. The reconstituted curcumin mixture used by most Life Extension members today is called BCM-95®.14

What Is Rheumatoid Arthritis?

Although many people use the term "arthritis" to refer to any condition involving painful, achy, swollen joints, there are actually several different forms of the disease. The most common form of arthritis is osteoarthritis, formerly known as "degenerative arthritis." While less common than osteoarthritis, rheumatoid arthritis still affects some 1.5 million US adults.36 Rheumatoid arthritis is more than twice as prevalent among women as among men.37

Rheumatoid arthritis is an inflammatory disease that most obviously affects the joints, but its impact is seen in tissues and organ systems throughout the body. Inflammation centers on the membranes lining the affected joints, causing them to swell, limiting their movement, and causing pain. Over time, those inflamed membranes erode the cartilage that normally cushions the joint, and eventually they even erode away the bone itself. That can deform the joint and further impair movement.

Symptoms of rheumatoid arthritis are pain, swelling, and redness of the joints. It can begin at any age (unlike osteoarthritis, which doesn't occur until at least mid-life). There is as yet no known cure for rheumatoid arthritis.37

Recent science is showing that osteoarthritis has a major inflammatory component as well, contrary to our long-held beliefs.38 That's good news for the millions of sufferers of osteoarthritis, because curcumin's powerful and multi-targeted suppression of inflammation may offer relief for them as well as for those with rheumatoid disease.

Clinical studies of BCM-95® in human volunteers have shown that its bioavailability is nearly seven times greater than that of a standard extract of curcumin.14,15 BCM-95® was also more than six times as bioavailable as a leading mixture of curcumin with two other natural products, lecithin and piperine.14 BCM-95® is not only better absorbed than standard curcumin, it achieves significant blood levels and remains in the blood longer (See figure 1 above).15 This means that your body can reap the beneficial effects of curcumin for considerably longer. This advantage applies not only to rheumatoid arthritis, but to other conditions for which curcumin may be indicated.

Highly Bioavailable Curcumin Fights Fat-Related Inflammation

The availability of the highly bioavailable form of curcumin, BCM-95®, is making possible new progress in old diseases. BCM-95® was recently shown in an animal study to reduce the amount of inflammation associated with obesity, a major cause of accelerated aging, diabetes, and other chronic diseases.24,39 In that study BCM-95® also reduced levels of one particular inflammatory molecule, IL-2 that is associated with loss of brain cells in Alzheimer's disease.39 These early reports illustrate the tremendous potential associated with the dramatic enhancement in bioavailability of curcumin in tissues throughout the body.

Curcumin and Osteoarthritis

Osteoarthritis, long thought to be a purely "degenerative" disease, is now recognized to have multiple inflammatory components. Scientists are rapidly exploring curcumin's potential role in suppressing those inflammatory processes.

One of the key features of osteoarthritis is the breakdown of the slippery cartilage that lines joints, lubricating them and cushioning them from the impact of constant use.12 That cartilage breakdown is triggered by multiple pro-inflammatory signaling molecules, many of which are secreted from the membranes that line the joint.10

Studies now show that curcumin can protect this vital lubricating cartilage in several ways. Curcumin directly counteracts the effect of those inflammatory molecules, especially within cartilage cells themselves.12 In the joint-lining membranes, curcumin suppresses the growth of the inflammatory cells that are responsible for cartilage destruction.20 And curcumin even inhibits the "cartilage-eating" enzymes that carry out the destructive process itself.21,22

A pair of human studies showed that joint pain was reduced and joint function was improved, in patients taking a commercial curcumin complex that was formulated to improve absorption.23 Those studies, like the one detailed above, also demonstrated improvements in blood tests measuring inflammation.

Curcumin Fights Cancer

Curcumin is taking center stage in the fight against cancer. To date, curcumin has been shown in human clinical trials to prevent or mitigate cancers of the gastrointestinal tract (such as colorectal and esophageal cancers), the breast, prostate, liver, cervix, and skin, as well as a form of leukemia, chronic lymphocytic leukemia, common in older adults.41-44 Promising results are also being published in studies of curcumin and pancreatic cancer, one of the deadliest cancers that afflict humans.45-48 Most of these trials have been early stage studies, with small numbers of subjects, but their preliminary results are encouraging.

Animal and basic lab science studies are shedding increasingly clear light on just how curcumin exerts its anticancer activities. Here's what we know:

Curcumin prevents DNA damage. Damage to your DNA is inevitably the first step in cancer development. Damaged or "mutated" DNA can trigger unbridled growth of cells that lack normal restraints, leading to a full-blown tumor. Studies show that curcumin can reduce the rate of cancer-inducing DNA damage.49,50 In one human study, colon cancer patients supplemented with curcumin (up to 3.6 g/day for 7 days) had a 58% reduction in DNA damage in their intestinal tissue.51

Curcumin quenches the fires of inflammation. Inflammatory processes throughout your body promote cancer development. Curcumin acts at multiple molecular targets to shut down chronic inflammation and reduce production of the chemical cytokines that promote it, directly reducing your risk of developing a tumor.49,52,53 When a group of colon cancer victims took curcumin (3.6 g/day for four months), their blood levels of inflammatory cytokines dropped by up to 62%.49

Curcumin promotes cancer cell suicide. Normal cells are equipped with a "self-destruct" program that causes them to die if they begin to reproduce too fast or become damaged in ways that could harm your body. Cancer cells disable that program early in their progression, allowing their explosive replication. Curcumin switches the self-destruct program back on, causing abnormal cells to quickly bow out.54-56

Curcumin breaks the link between obesity and cancer. The risk of almost all cancers is increased in obesity. That's in part because of raised insulin levels seen in obese people and those with type 2 diabetes (insulin is a growth factor that promotes cancer development).17 By reducing insulin resistance, curcumin helps lower your insulin levels and reduce your cancer risk.57, 58

Curcumin suppresses molecules cancers need to sustain their growth and invade your tissues. As tumors grow, they stimulate formation of new blood vessels to support their voracious appetites for nutrients and oxygen. They over-produce molecules that help them "stick" to adjacent tissue and invade it. Finally, they make enzymes that literally "melt" the protein glue that holds normal tissues together, allowing them to spread to far away parts of the body through metastasis. Curcumin acts to suppress production of many of these cancer-promoting chemicals.59

Curcumin stops pre-malignant tissue from progressing. Cancers in some organs, such as the intestine and cervix, develop slowly enough that we can detect areas of abnormality before they turn malignant. Removing them, however, requires invasive procedures that don't always catch every lesion and that bring with them some risk of their own. Human studies show that curcumin supplementation triggers improvement in precancerous lesions of the bladder, mouth, stomach, and cervix.41,60 Curcumin supplementation reduced the number and size of precancerous intestinal polyps by 60% and 51%, respectively, in people at high risk for colon cancer.61

Increased risk of infection,28-30 injection site reactions,28,29 may interfere with responses to vaccination,27 disturbed lipid profile31

Summary

Inflammation lies at the heart of virtually all diseases associated with aging. In fact, people with inflammatory conditions experience accelerated aging that affects every tissue and organ in their bodies.

Rheumatoid arthritis is one of the most aggressive and destructive of the inflammatory conditions that afflict humans, and it is one that has proven resistant to all but the most dangerous forms of standard medical treatment.

Curcumin has held out great hope for management of all kinds of inflammatory diseases, but its benefits have been hampered by its poor absorption and availability to inflamed tissues. A superior-absorbing curcumin formulation( BCM-95®) has up to 7 times the bioavailability of commercial products.

A clinical trial of BCM-95® among sufferers of active rheumatoid arthritis demonstrated not only that the formula was safe, but also that the effectiveness of only 500 mg a day exceeded that of a standard anti-inflammatory drug.5

Additional new studies suggest that this curcumin formula can reduce obesity-associated inflammation as well.24 Together, these findings suggest that highly bioavailable curcumin represents an entirely new chapter in the management of some of humankind's most feared diseases.

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